| NPI | 1790755395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G159714) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000559) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-092601) | |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: IA F-092601) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-05-31 |